Active NPI
Charles Brent Wilson, D.D.S.
- General Practice Dentistry
- Saint Francisville, LA
National Provider Identifier
1629399522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6033
- Practice address
- 7689 US Hwy 61
Saint Francisville, LA 70775-0820 - Phone
- (225) 635-6554
- Fax
- (225) 635-6239
- NPI assigned
- Jun 15, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6033 | LA | Primary |
Addresses
Primary practice location
7689 US Hwy 61
Saint Francisville, LA 70775-0820
Mailing address
PO Box 474
7689 US Hwy 61
Saint Francisville, LA 70775-0474
Phone (225) 635-6554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6033 | LA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles Brent Wilson DDS LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba St. Francisville Family Dentistry
- General Practice Dentistry
- Saint Francisville, LA
- NPI 1962723502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375056000000",
"number": "1629399522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 474",
"address_2": "7689 US HWY 61",
"city": "SAINT FRANCISVILLE",
"state": "LA",
"postal_code": "707750474",
"telephone_number": "225-635-6554",
"fax_number": "225-635-6239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7689 US HWY 61",
"city": "SAINT FRANCISVILLE",
"state": "LA",
"postal_code": "707750820",
"telephone_number": "225-635-6554",
"fax_number": "225-635-6239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "CHARLES",
"middle_name": "BRENT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-15",
"last_updated": "2013-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "6033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Francisville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.